Individual
OSTAP DOVIRAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
850 LAWRENCEVILLE SUWANEE RD STE 101, LAWRENCEVILLE, GA 30043-5483
(770) 963-2451
(770) 962-0017
Mailing address
1930 BRANNAN RD, MCDONOUGH, GA 30253-4310
(678) 284-4040
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
0101257619
VA
208800000X
Urology Physician
258802
MA
208800000X
Urology Physician
Primary
98455
GA
Other
Enumeration date
04/28/2009
Last updated
04/29/2024
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